Bellack A S, Mueser K T
Community Ment Health J. 1986 Fall;22(3):175-89. doi: 10.1007/BF00756980.
The failure of deinstitutionalization and the community mental health movement to improve the treatment of chronic psychiatric patients, particularly schizophrenics, is described. Problems with the current treatment paradigm include unrealistic expectations concerning the rehabilitative effects of antipsychotic medications, inadequate funding of the community mental health system, and the predominance of the "infectious disease model," rather than the more appropriate "chronic disease model" of mental illness. A model for the comprehensive treatment of chronic mental illness is proposed that includes: treatment, rehabilitation, social services, and continuity of care. The need for an integrated community approach to rehabilitating chronic psychiatric patients is stressed, and some of the specific ingredients essential to such a program are identified.
文中描述了非机构化和社区心理健康运动在改善慢性精神病患者（尤其是精神分裂症患者）治疗方面的失败。当前治疗模式存在的问题包括：对抗精神病药物康复效果的期望不切实际、社区心理健康系统资金不足，以及精神疾病的“传染病模式”占主导地位，而非更合适的“慢性病模式”。文中提出了一个慢性精神疾病综合治疗模式，包括：治疗、康复、社会服务和持续护理。强调了采用综合社区方法来康复慢性精神病患者的必要性，并确定了此类项目必不可少的一些具体要素。
